How Permanent Partial Disability Ratings Are Determined
Workplace injuries can leave lasting effects, especially when the damage is serious enough to prevent someone from ever regaining full function. In California, employees who suffer permanent but not total injuries may receive compensation through a permanent partial disability (PPD) rating.
Workers across California rely on permanent partial disability ratings to help support them financially when returning to their job isn’t fully possible. With help from the experienced workers' compensation lawyer at The Law Office of Cezar J. Torrez in Sacramento, California, you can better understand the process and pursue full benefits.
What Is a Permanent Partial Disability Rating?
A permanent partial disability (PPD) rating is a number assigned by a doctor to describe how much a work injury has permanently affected your ability to function. It applies when an injury has reached what’s known as Maximum Medical Improvement (MMI), meaning your condition has stabilized and isn’t expected to improve with further treatment.
This rating doesn’t mean you can’t work at all—it just reflects that a specific body part or system no longer works the way it did before the injury. The California workers’ compensation system uses this rating to determine how much compensation you’re eligible for moving forward.
The Process of Reaching Maximum Medical Improvement
Before a PPD rating is assigned, your doctor must determine that you've reached MMI. This is a medical judgment that your condition has plateaued—it’s not getting worse, but it’s also not expected to improve. It usually comes after weeks or months of treatment, rehabilitation, or surgery.
Once MMI is declared, a doctor will evaluate any lasting impairment. If you're unhappy with that assessment, you can seek a second opinion through a Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME), especially with guidance from a workers' compensation lawyer.
Factors That Affect a PPD Rating
The state of California follows strict rules when assigning PPD ratings. The goal is to apply a fair and standardized system to every injury. Multiple factors are taken into account to determine the final number. Elements that influence your PPD rating include:
Body part affected: Ratings vary depending on which part of the body is injured and how essential it is to your work or daily life.
Medical impairment rating: Based on guidelines from the American Medical Association (AMA), this percentage reflects the degree of permanent physical or mental loss.
Age at the time of injury: Younger workers may receive higher ratings because they potentially face longer-term effects.
Occupation: How your injury affects your ability to perform your specific job duties plays a role in the rating.
Adjustments and modifiers: California law applies adjustments based on age and occupation to modify the impairment rating.
These elements are combined to calculate a final percentage that reflects your permanent disability. That percentage will influence the duration and amount of your PPD payments.
The Disability Evaluation Unit
Once the doctor’s report is submitted, the Disability Evaluation Unit (DEU) may review the case and offer a formal rating. This rating is based on your impairment percentage and adjusted according to your job and age. The DEU evaluator isn’t a medical provider, but rather someone trained to apply the law and guidelines to your medical report.
If you disagree with the DEU's determination, you have the right to dispute it. A workers' compensation lawyer can help file the proper paperwork and present evidence to challenge the rating, increasing the chance of a fair outcome.
Using the AMA Guides in California
California uses the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, to determine impairment levels. These guides offer doctors standardized criteria to assess loss of function for different injuries. They aim to promote consistency, but applying the criteria to realistic injuries can sometimes lead to disagreement.
Because the interpretation of the AMA Guides can vary, especially when a case involves subjective symptoms like pain or mental health conditions, having a workers' compensation lawyer is extremely helpful. They can help you challenge vague or inconsistent conclusions in your medical report.
Adjustments Based on Your Job and Age
Two injured workers with similar injuries may receive different PPD ratings depending on their age and job description. California law recognizes that a back injury, for example, may affect a construction worker more severely than a desk worker.
The age modifier reflects that a younger person may face long-term limitations, while an older person might already be nearing retirement. These modifiers are applied to the initial impairment rating to produce a more tailored disability percentage.
This process highlights the need for a precise job description and accurate medical reporting. A workers' compensation lawyer can help you make sure that your information is presented clearly and favorably.
How PPD Ratings Affect Compensation
Once your PPD rating is finalized, it’s used to calculate how many weeks of benefits you’ll receive and how much you’ll be paid each week. California workers’ compensation law includes a schedule that assigns a dollar value and duration to different rating percentages. How your PPD rating determines compensation:
Ratings between 1% and 99% qualify as permanent partial disability.
Each percentage point corresponds to a certain number of weeks of benefits.
The total payment amount depends on your average weekly wage and rating.
You may receive advances on your payments during the process.
Lump sum settlements may be offered in some cases.
The higher your rating, the more compensation you're entitled to. Disputing a low rating is often worth it because even a few percentage points can significantly increase your benefits.
Disputing a PPD Rating
If you disagree with the rating issued by the evaluating doctor or DEU, you have the right to contest it. This usually involves requesting a second evaluation from a Qualified Medical Evaluator (QME) or, in some cases, an Agreed Medical Evaluator (AME).
You may also challenge the application of job or age modifiers or the interpretation of the AMA Guides. It’s crucial to act quickly—there are strict deadlines in the workers' compensation process. A workers' compensation lawyer at The Law Office of Cezar J. Torrez can help you meet those deadlines and build a case for a more accurate rating.
Settlements and Ratings
Your PPD rating can also influence the type of settlement you might be offered. There are two primary types of settlements in California: a Stipulated Finding and Award, and a Compromise and Release. The first is based on the established rating, and the second allows for a full buyout of benefits, sometimes before a final rating is even determined.
Settlements can offer faster resolution, but they also require you to give up certain rights. Before agreeing to anything, it’s recommended to consult a workers' compensation lawyer to be sure the amount reflects your long-term needs.
What Happens After Benefits End?
Once your PPD payments are complete, you may still need support. If you’re unable to return to your previous job, California’s Supplemental Job Displacement Benefit may offer you a voucher to retrain or pursue a different career path.
In cases where your injury continues to interfere with your ability to work, additional benefits may be available through state or federal programs. A workers' compensation lawyer can help you understand your next steps and explore all your options for long-term recovery and financial stability.
Importance of Legal Representation
The workers’ compensation system can be difficult to deal with, especially when you're recovering from an injury. A workers' compensation lawyer can protect your rights and help you receive a fair PPD rating. They’ll make sure your medical records are complete, help you choose an impartial QME, and represent you in any disputes.
Lawyers also know how to interpret the AMA Guides, challenge faulty evaluations, and negotiate settlements that reflect the true value of your injury. You shouldn’t have to go through this process alone or settle for less than what you're owed. Benefits of working with a workers' compensation lawyer:
Assistance gathering and submitting medical documentation.
Representation during evaluations and appeals.
Help calculating the correct rating and benefits.
Negotiation of fair settlements.
Clear advice about deadlines and rights.
Even if you haven't had issues yet, consulting a lawyer early in the process can prevent costly mistakes and protect your benefits down the road.
Contact The Law Office of Cezar J. Torrez Today
Permanent partial disability ratings play a major role in shaping the benefits injured workers receive after an accident. At The Law Office of Cezar J. Torrez, I help injured workers across East Sacramento, Oak Park, South Natomas, North Sacramento, West Sacramento, North Natomas, Arden-Arcade, Rosemont, Lemon Hill, Pocket, Riverview, and surrounding California communities. Contact me today.